An Information Technology Framework for Predictive, Preventive and Personalised Medicine : A Use-Case with Hepatocellular Carcinoma

This book explores how PPPM, clinical practice, and basic research could be best served by information technology (IT). A use-case was developed for hepatocellular carcinoma (HCC). The subject was approached with four interrelated tasks: (1) review of clinical practices relating to HCC; (2) propose an IT system relating to HCC, including clinical decision support and research needs; (3) determine how a clinical liver cancer center can contribute; and, (4) examine the enhancements and impact tha…

This book explores how PPPM, clinical practice, and basic research could be best served by information technology (IT). A use-case was developed for hepatocellular carcinoma (HCC). The subject was approached with four interrelated tasks: (1) review of clinical practices relating to HCC; (2) propose an IT system relating to HCC, including clinical decision support and research needs; (3) determine how a clinical liver cancer center can contribute; and, (4) examine the enhancements and impact that the first three tasks will have on the management of HCC. An IT System for Personalized Medicine (ITS-PM) for HCC will provide the means to identify and determine the relative value of the wide number of variables, including clinical assessment of the patient -- functional status, liver function, degree of cirrhosis, and comorbidities; tumor biology, at a molecular, genetic and anatomic level; tumor burden and individual patient response; medical and operative treatments and their outcomes.

Defining prevention science

Whoever coined the adage "an ounce of prevention is worth a pound of cure" could not have known how important this adage would become. The challenge of altering the health trajectories of poor lifestyle decisions for such behaviors as smoking, drinking, and using illicit drugs, violence, dropping out of school, engagement in risky sexual behaviors, and crime through prevention research has led to a new discipline, prevention science. DefiningPrevention Science covers this emerging field of scie…

Whoever coined the adage "an ounce of prevention is worth a pound of cure" could not have known how important this adage would become. The challenge of altering the health trajectories of poor lifestyle decisions for such behaviors as smoking, drinking, and using illicit drugs, violence, dropping out of school, engagement in risky sexual behaviors, and crime through prevention research has led to a new discipline, prevention science. DefiningPrevention Science covers this emerging field of science: its goals,its conceptual and theoretical foundations, its methods, and especially its utility. Not content to simply differentiate the field from its close allies: epidemiology, psychology, neuroscience, sociology, economics, the text explains how these many disciplines enhance each other at both research and intervention levels, and how prevention science draws on these biological, behavioral, and social sciences to create an innovative knowledge base that has provided cost-effective, evidence-based prevention interventions and policies. To this end, familiar developmental benchmarks are recast in prevention/health promotion context, from the crucial importance of adolescence in encountering and deterring high-risk behaviors to the risks and resiliencies of single-mother families. An international group of contributors offers current findings, up-to-date methods for effective evidence-based interventions, and improvements in research technologies in these key areas: Physical, cognitive, and emotional vulnerability across the life course. The roles of developmental influences in prevention. Intervention development, delivery, and implementation. Bringing the intervention approach to research design. New directions in analytic methods. Cost analysis and policy implications. Defining Prevention Science aims to inspire further refinements in the field and encourage communication among researchers in its own and related disciplines, including public health, epidemiology, psychology, and criminology. This is the first volume in the series, Advances in Prevention Science, that provides the framework for other volume that will focus on such issues as: Prevention Science in School Settings: Complex Relationships and Processes; Preventing Crime and Violence; and The Prevention of Substance Use.

Contents

Prevention Science: An Epidemiological Approach -- Part I. Individual Physical, Cognitive, and Emotional Vulnerability Across the Life Course: Benchmarks and Developmental Challenges -- Benchmarks, Developmental Challenges, and Risks During the Prenatal and Infancy Period -- Childhood and the Entry into Adolescence: A Pivotal Period in Health-Related Behaviors and Prevention -- Adolescence and Early Adulthood -- Stressors and Vulnerabilities in Middle and Old Age: Opportunities for Prevention -- Part II. Environmental Influences and Implications for Intervention Development -- Family -- School Influences on Child and Youth Development -- Peer Networks -- Risk and Resilience Processes in Single-Mother Families: An Interactionist Perspective -- Environmental Influences: The Workplace and Mental Health-Models, Vulnerability Factors, and Interventions -- An Integrated Prevention Science Model: A Conceptual Foundation for Prevention Research -- Design of Prevention Interventions -- Implementation Science and the Effective Delivery of Evidence-Based Prevention -- Factors Affecting Implementation: Cultural Adaptation and Training -- Measuring Fidelity -- Part III. Research Design -- Translating the Intervention Approach into an Appropriate Research Design: The Next-Generation Adaptive Designs for Effectiveness and Implementation Research -- The Epidemiologic Case-Crossover and Case-Control Approaches in Prevention Research -- The Use of Simulation Models in Public Health with Applications to Substance Abuse and Obesity Problems -- Meta-analysis in Prevention Science -- Mixed Methods Research Design for Prevention Science: Methods, Critiques, and Recommendations -- Part IV. Analytic Methods -- Latent Class Analysis in Prevention Science -- Discrete-Time Survival Analysis in Prevention Science -- Using Mediation and Moderation Analyses to Enhance Prevention Research -- Advances in Missing Data Models and Fidelity Issues of Implementing These Methods in Prevention Science -- Part V. Cost Analysis and Policy -- Economic Analysis and Policy Studies: Special Challenges in the Prevention Sciences -- Strengthening Prevention Science to Ensure Effectiveness of Intervention in Practice: Setting up an International Agenda.

The writings of earliest civilizations reveal that diabetes mellitus has afflicted man for a very long time. Unfortunately, however, we are now experiencing a world-wide pandemic of the disease which has not been adequately addressed. Available evidence suggests that worldwide every 10 seconds one patient dies of diabetes and its severe complications. The outlook is even more bleak with the prediction of half of a billion diabetic patients by the year 2030. The cost-impact of the disease poses …

The writings of earliest civilizations reveal that diabetes mellitus has afflicted man for a very long time. Unfortunately, however, we are now experiencing a world-wide pandemic of the disease which has not been adequately addressed. Available evidence suggests that worldwide every 10 seconds one patient dies of diabetes and its severe complications. The outlook is even more bleak with the prediction of half of a billion diabetic patients by the year 2030. The cost-impact of the disease poses a major challenge for both developed and developing countries and their economies. Thus, it is high time to reconsider and revise the current strategies in diabetes care. Accordingly, a paradigm shift from reactive to perspective medicine has become a timely consideration. This shift is based on the concept of Predictive, Preventive and Personalized Medicine (PPPM). The rationale for PPPM relates to the recognition that prediction of persons at high risk for the disease (i.e., diabetes mellitus) should help devise strategies to prevent its target organ complications, and create effective treatments tailored to the individual patient, thereby reducing morbidity, and associated costs, and mortality. The current book entitled 'New Strategies to Advance Pre/Diabetes Care: Integrative Approach by PPPM' is intended to serve as a reference source for researchers and the healthcare industry with a special emphasis on health promotion in the general population and help design innovative strategies to prevent the onset of diabetes mellitus and its secondary complications.

Contents

Global Figures Argue in Favour of Preventive Measures and Personalised Treatment to Optimise Diabetes Care -- Three Levels of Prediction, Prevention & Individualised Treatment Algorithms to Advance Diabetes Care: Integrative Approach -- Diabetes mellitus: new challenges and innovative therapies -- Identification of Biomarkers for beta cell failure as detection tools for predictive screening in type 2 pre-Diabetes -- Endothelial dysfunction in diabetes: role of circulating biomarkers as potential diagnostic and prognostic tolls -- Endothelial progenitor dysfunction in the pathogenesis of diabetic retinopathy: treatment concept to correct diabetes-associated deficits -- Oxidative stress and apoptotic biomarkers in diabetic retinopathy -- Diabetic Retinopathy: the Need for Predictive, Preventive and Personalized Approach to Management -- The role of inflammatory cytokines in diabetic nephropathy: Potential use as predictive markers for early detection and progression -- Preventing hyperglycemia and tissue injury in diabetes: The dynamic role of 2,3 dioxygenase in diabetes and its complications -- An Integrative Approach to Chronic Wounds in Patients with Diabetes: PPPM in Action -- Understanding inflammation as the key to targeted preventive measures for diabetes in relation to periodontics -- Cancer predisposition in diabetics: risk assessment and targeted preventive measures -- Recognition of individual risks by analysis of subcellular imaging insights into chromium picolinate therapy in pre/diabetes care, search into its safety and opinion controversy -- Remote control in diabetes -- Drug delivery systems for predictive medicine: polymers as tools for advanced application -- Author Index -- Subject Index.

Preventive and Predictive Genetics : Towards Personalised Medicine

Traditionally, medical research comprised of the identification of the pathological causes of a disease, its epidemiology and empirical investigation of treatment response. Intensive genetic research, marked by the completion of the human genome project in 2003, heralded a new era in medical research. While epidemiology and gross pathology are still mainstay useful tools, genetics and genomics have gradually been shown to increase the resolution of drug response research, showing great potentia…

Traditionally, medical research comprised of the identification of the pathological causes of a disease, its epidemiology and empirical investigation of treatment response. Intensive genetic research, marked by the completion of the human genome project in 2003, heralded a new era in medical research. While epidemiology and gross pathology are still mainstay useful tools, genetics and genomics have gradually been shown to increase the resolution of drug response research, showing great potential in also informing and identifying the role of genes and their encoded products in the pathophysiology of diseases. This information is already being applied in the prevention of illness, effective early diagnosis, better risk assessment (prognosis), as well as targeted effective and safe treatment allocation (prediction and monitoring). Genetic testing and genomics support personalised medicine by translating genome-based knowledge into clinical practice, offering enhanced benefit for patients and health-care systems at large. Current routine practice for diagnosing and treating patients is conducted by correlating parameters such as age, gender and weight with risks and expected treatment outcomes. In the new era of personalised medicine the healthcare provider is equipped with improved ability to prevent, diagnose, treat and predict outcomes on the basis of complex information sources, including genetic and genomic data. Targeted therapy and reliable prediction of expected outcomes offer patients access to better healthcare management, by way of identifying the therapies effective for the relevant patient group, avoiding prescription of unnecessary treatment and reducing the likelihood of developing adverse drug reactions.